OPHTHALMALOGICA – Peer-reviewed journal of EURETINA

  CLOT-BUSTER EFFECTIVE IN SUBRETINAL HAEMORRHAGES Vitrectomy combined with subretinal rtPA injection and gas or air tamponade can improve vision and reduce lesion size in eyes with subretinal haemorrhages (SRHs) alone and with combined subretinal and subpigment epithelial haemorrhages (SPHs). The treatment also seems to slightly improve the anatomical outcome in eyes with SPH alone, an observational study suggests. It showed that among 19 eyes with SRH and 53 eyes with combined haemorrhages, the mean best corrected visual acuity (BCVA) improved significantly following treatment. There were also significant reductions in maximal haemorrhage diameter (MHD), and central macular thickness (CMT) (p<0.05). M Waizel et al, “Efficacy of Vitrectomy Combined with Subretinal Recombinant Tissue Plasminogen Activator for Subretinal versus Subpigment Epithelial versus Combined Haemorrhages”; Ophthalmologica 2016, Volume 236, Issue 3. HIGH INTRAVITREAL VEGF LEVELS PREDICT WORSE VITRECTOMY OUTCOMES Patients with proliferative diabetic retinopathy (PDR) who have higher levels of intravitreal vascular endothelial growth factor (VEGF) have a significantly worse postoperative visual acuity following vitrectomy than those with lower levels, a new study suggests. It showed that, among 136 eyes of 114 PDR patients vitrectomised between 2006 and 2008, corrected visual acuity six months after surgery was significantly worse in those with intravitreal VEGF levels 5,000 pg/mL or higher than it was in those with higher levels of the growth factor (p=0.02). Reoperations were also significantly less common among those with low VEGF levels. Y Suzuki et al, “Level of Vascular Endothelial Growth Factor in the Vitreous Fluid of Proliferative Diabetic Retinopathy Patients and Prognosis after Vitrectomy”; Ophthalmologica 2016, Volume 236, Issue 3. HYPHAEMA FOLLOWING VITRECTOMY High myopia and scleral buckling procedures combined with vitrectomy are risk factors for postoperative hyphaema following surgery for primary rhegmatogenous retinal detachment (RRD), a new study suggests. Among 1,011 consecutive eyes that underwent surgery for RRD, 32 had postoperative hyphaema. A comparison between eyes with and without the complication indicated that the likelihood of hyphaema was over three times higher among high myopes (odds ratio 3.396; p=0.003), and over 20 times higher among those who underwent a combined scleral buckling-vitrectomy procedure (OR 21.266; p<0.001), than among the patients overall. Y Kung et al, “Risk Factors for Hyphema following Surgeries for Primary Rhegmatogenous Retinal Detachment”; Ophthalmologica 2016, Volume 236, Issue 3.